Abstract
Objective: To evaluate the efficacy of the early two-stage palatoplasty regimen (ETS) advocated by Nishio et al. in 1997, in this paper we report speech results at 4 years of age on children treated by this method.
Materials and Method: Thirty complete unilateral cleft lip and palate (CUCLP) treated by ETS were examined (ETS group). ETS consists of velar closure using the modified Furlow technique at 12 months of age and hard palate closure at 18 months of age. We compared the speech results of the ETS group with those of 41 patients treated by the one-stage pushback method at 12 months of age (PB group).
Results: 1. The ETS group tend ed to be later in acquiring oral function and producing consonants than the PB group. The beginning ages of sucking, blowing and producing labial consonants were significantly delayed in the ETS group. This procrastination in the ETS group might have resulted from the residual cleft in the hard palate being left open until 18months of age.
2. At 4 ye ars of age both surgical techniques resulted in good speech in the majority of patients. Velopharyngeal competency was competent in 93.3% of the ETS group and 95.1% of the PB group.76.7% of patients in the ETS group and 63.4% in the PB group acquired normal articulation. Six patients (20.2%) in the ETS group and 12 patients (29.3%) in the PB group had palatalized articulation. The kind of these palatalized consonants was dento-alveolar consonants in the ETS group. In the PB group, we recognized dento-alveolar consonants and postalveolar consonants. This difference in the kind of palatalized consonants between the ETS group and PB group might be a reflection of the better growth of upper dental arch in the ETS group.
Conclusion: This report revealed that the speech results of the ETS group at 4 years of age were better than those of the PB group.
